Despesa de operadoras cresce mais do que valor de planos de saúde, diz federação
Em debate na comissão que analisa mudanças na lei do setor, representante de planos de saúde sugere medidas para conter aumento de custos
O diretor-executivo da Federação Nacional de Planos de Saúde (FenaSaúde), José Cechin, informou nesta terça-feira (20) que, de 2007 a 2016, o reajuste de preços feitos pelas operadoras de planos de saúde foi de 115,4%, diante da inflação de 74,7% (IPCA), mas destacou que a despesa assistencial per capita paga pelas operadoras aumentou 158,7%.
Em audiência pública na comissão especial (PL 7419/06 e 139 apensados) que analisa mudanças na atual lei do setor (9.656/98), Cechin listou medidas que poderiam conter esse aumento de custos, como uma rede hierarquizada com direcionamento, com um médico de família coordenando os cuidados – modelo similar ao Sistema Único de Saúde (SUS).
Além disso, Cechin sugeriu a coparticipação do usuário nas consultas, reduzindo desperdícios, e protocolos clínicos bem definidos, iguais aos do SUS. Ele defendeu ainda a possibilidade de planos regionalizados e a obrigatoriedade de segunda opinião médica em casos de maior complexidade.
Cechin também citou os itens mais judicializados: contratos antigos; reajustes anuais e por mudança de faixa etária; negativas de coberturas; mudanças na rede credenciada; aposentados e demitidos; carências; e reembolsos. E sugeriu alteração na lei para mitigar a judicialização, como o aclaramento das situações de urgência e emergência; e a exclusão de cobertura de tratamentos não-contratados ou de caráter experimental.
Mudança de modelo
O vice-presidente da Confederação Nacional de Saúde (CNS), Marcelo Moncorvo Britto, afirmou que os planos privados de assistência de saúde perderam usuários, e logo aumentou a sobrecarga do SUS. Ele também ressaltou que os usuários criticam sobretudo a cobertura, que seria responsável por mais de 2/3 das reclamações. Ele apontou ainda que o mercado está muito concentrado nas mãos de poucas empresas e reclamou que o custo assistencial para as operadoras está subindo mais do que a receita.
Britto sugeriu a mudança do modelo – hoje focado na “relação prestador x operadora, com exclusão do usuário” – para um “focado na relação usuário x prestador, com participação necessária da operadora”. Além disso, ele acredita que os prestadores e médicos devem ser direcionados à saúde básica e preventiva, e não à saúde de alta complexidade, como é hoje.
O deputado Vitor Lippi (PSDB-SP) concorda que o modelo deve ser alterado para se focar na prevenção, e não na doença. “Temos que atuar na promoção da saúde”, disse.
Judicialização
Especialista em questões ligadas a planos de saúde, o desembargador aposentado do Tribunal de Justiça de São Paulo Maury Ângelo Bottesini afirmou que a judicialização da saúde no País é causada pela constitucionalização da saúde. A Constituição diz que saúde é direito de todos e dever do Estado.
Segundo ele, o Brasil é um pouco dos países do mundo que garante essa universalidade, gerando diversas demandas judiciais. Ele ressaltou que o País não tem recursos para garantir essa universalidade. “O SUS é uma maravilha no papel, no entanto falta o mecanismo econômico-financeiro para que se cumpra a Constituição”, disse.
Além disso, o desembargador defendeu a reforma da lei para divida-la em capítulos e facilitar a regulamentação pela Agência Nacional de Saúde (ANS), e sugeriu que seja retirada da legislação a parte que traz “um verdadeiro código penal para conselheiros e operadores de planos de saúde”.
O deputado Jorge Solla (PT-BA) acredita que o caminho não pode ser desconstitucionalizar a saúde, mas criar políticas públicas para garantir que esse direito seja efetivado. Ele disse que o principal problema do setor é o subfinanciamento e criticou a Emenda Constitucional 95 aprovada pelo Congresso que estabelece um teto para os gastos públicos nos próximos 20 anos.
Fonte: http://www.segs.com.br
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